Friday, 5 June 2015

Culturally-sensitive model identifies health issues early

A health model to identify and treat mental illness in Aboriginal men will be the focus of an Australia-wide webinar on 18 June 2-3 pm as part of national Men’s Health Week. (Register for details on how to join the webinar.)

Mental disorders are the second leading cause of disease burden in Indigenous communities after cardiovascular disease.

 Monash University School of Rural Health researcher and lecturer, Dr Anton Isaacs, hopes the webinar presentation will lead to other regional and rural communities trialling, and eventually implementing, the model.

Community-led health check

Mental health services and local Aboriginal Elders, who support the health model, will participate in the webinar. These include local Elder and police liaison officer Laurie Marks; local Elder Rex Solomon who works with the Victorian Department of Education; local Elder Cliff Wandin, who is highly regarded in his community; Berwyn Lampitt, a senior mental health nurse at Latrobe Regional Hospital; and Dr Isaacs.

 Dr Isaacs, who is based at Monash University Department of Rural and Indigenous Health (MUDRIH) in Moe, has been instrumental in the design and set up of mental health services for rural and regional people who are medically under-served. Aboriginal people form a large part of this cohort.

Alarming health statistics

It is the alarming mental health statistics in his area of Gippsland, Victoria - and across Australia more broadly – which have inspired Dr Isaacs’ work.

 “Many indigenous people don’t know they have a mental health problem and if they do, they find it difficult to talk about it,” he said.

 “This may lead them to attempt suicide or become involved in crime.

 “Very few Aboriginal men go directly to a mental health service for help; it’s usually via the judicial system.”

 Dr Isaacs spent several years working within his local Aboriginal community until he became a “trusted friend”.

The vital role of Elders

He soon observed that Indigenous men find a closed, sterile environment unsettling; they prefer to sit outside to have “a yarn”; they experience significant gender issues discussing sensitive problems with women; and any meeting place must be culturally appropriate.

 Dr Isaacs put a proposal to the local Elders to host a Koori Men’s Health Day which sought to overcome some of these barriers. He knew the model needed to be sustainable and acceptable to the Aboriginal community and, critically, men needed to come.

Most importantly, the model provided a way for the Aboriginal community to take ownership of it.

According to Dr Isaacs, that’s where the Elders played a vital role, suggesting a local community hall as the setting for the day. Aboriginal men were invited along for a “yarn” and a barbecue, and in the process, would undergo health checks. He said attendance was beyond his expectations.

“The health check was constructed in such a way that there was no mention of the word ‘mental’ so the whole issue of stigma was removed as a barrier to seeking help,” Dr Isaacs said.

Assembly line technique

The model adopted an assembly line technique. A medical examination was undertaken at the first station, a blood test at the second and finally, a mental health screening at the third.

The mental health screening was undertaken by the mental health triage team from the local mental health services whose members were all culturally competent.

“Having the Elders there made it much easier,” Dr Isaacs added. “While some men had the health check, others were chatting together and listening to several health-based presentations.

“If anyone was picked up at any of these stations as needing further medical treatment, they were referred to their general practitioner.

 “If there was a mental health problem evident, the triage team offered further follow-up in the mainstream service, where someone would be waiting to help them when they arrived, so they were meeting with people they already knew.”

A model that can be replicated

Dr Isaacs is confident if these health days can be repeated regularly, they offer an effective opportunity to identify not only psychological but also medical problems among Aboriginal men at a much higher rate than what is currently being achieved.

To date, two Koorie Men’s Health Days have been held with the second day being run by the Aboriginal community and supported by Dr Isaacs. “The Aboriginal community is very happy with this model and is currently exploring ways and means to run it on a regular basis.”

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